Microvascular changes during cerebral ischemia and reperfusion.
Microvascular changes during cerebral ischemia and reperfusion.
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发表时间：
1994
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通讯作者：
G. D. del Zoppo
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作者：
G. D. del Zoppo
虽然微血管室对血管内容量有显著贡献，但其对疾病的重要性常常被低估。围绕脑缺血的事件和最近对可能导致血栓性或栓塞性卒中中脑动脉再灌注的策略的兴趣，已经引起了对微血管系统在缺血和再灌注期间可能发挥的作用的询问。除了在少数情况下，很少有人知道在脑组织中的微血管组织。然而，很明显，缺血、炎性损伤和感染过程会影响脑微血管内皮、循环血室的细胞成分和止血。确切的机制正在研究中。从脑组织中分离的微血管系统的观察，软脑膜皮质血管的直接可视化，以及原位制备，使皮质下微血管的研究增加了我们对这些过程的理解。在局灶性脑缺血和再灌注期间，内皮细胞反应性、凝血系统激活和粒细胞-内皮细胞相互作用的改变是已经记录的影响微血管完整性的少数事件。氧自由基的产生，选择素和整合素的表达和细胞间粘附，血管扩张反应，内皮通透性的变化，凝血系统和血小板活化是目前正在研究的一些微血管过程，似乎是在缺血和再灌注过程中触发。鉴于这些事件，脑微血管对缺血性损伤的反应仍然相对未被探索。
Although the microvascular compartment contributes significantly to intravascular volume, its importance to disease is often underestimated. Events surrounding cerebral ischemia and recent interest in strategies which may lead to cerebral artery reperfusion in thrombotic or embolic stroke have raised enquiries about the role(s) the microvasculature may play during ischemia and reperfusion. Except in a few instances, little is known about the organization of the microvasculature in cerebral tissue. However, it is apparent that ischemia, inflammatory insults, and infectious processes affect the cerebral microvascular endothelia, cellular elements of the circulating blood compartment, and hemostasis. The precise mechanisms are under study. Observations in isolated microvascular systems from brain tissue, direct visualization of the pial cortical vasculature, and in situ preparations which allow study of the subcortical microvasculature have added to our understanding of these processes. During focal cerebral ischemia and reperfusion alterations of endothelial cell reactivity, coagulation system activation, and granulocyte-endothelial cell interactions are a few of the events affecting microvascular integrity which have been documented. Oxygen free radical generation, selectin and integrin expression and intercellular adhesion, vasomotor responses, endothelial permeability changes, and coagulation system and platelet activation are some of the microvascular processes currently under study which appear to be triggered during ischemia and reperfusion. In view of these events the responses of the cerebral microvasculature to ischemic injury remain relatively unexplored.